Jessy Fadel¹, Houssein Chebbo², Sarah Saleh², Karam Karam³*, Mazen Farhat⁴, Elias Saikaly⁵, Charbel Fares⁶ and Elias Fiani⁷

¹Department of Gastroenterology, Saint George University of Beirut, Lebanon
²Faculty of Medicine, University of Balamand, Dekweneh-Beirut, Lebanon
³Department of Gastroenterology, Faculty of Medicine, University of Balamand, Dekweneh-Beirut, Lebanon
⁴Department of Gastroenterology, Saint George University of Beirut, Lebanon
⁵Department of General Surgery, Saint George University of Beirut, Lebanon
⁶Department of Radiology, Saint George University of Beirut, Lebanon
⁷Associate Professor, Department of Gastroenterology, Faculty of Medicine, University of Balamand, Dekweneh-Beirut, Lebanon

*Corresponding Author: Elias Fiani, Department of Gastroenterology, Faculty of Medicine, University of Balamand, Lebanon.

Received: May 30, 2024; Published: June 25, 2024

Abstract

Background: It is an opportunistic pathogen causing disease mainly in immunosuppressed patients. Immunocompetent hosts may contract CMV infection and mostly demonstrate a benign subclinical disease ranging from being asymptomatic to a self-limiting, febrile mononucleosis-like syndrome accompanied with lethargy, arthralgia and hepatitis. Hereby we report an extremely rare case of invasive CMV pneumonia and hepatitis in an immunocompetent young adult.

Case: This is the case of a 38-year-old previously healthy male patient presenting with a 5-day duration of a high-grade fever measuring 39 °C. Laboratory workup was consistent with liver abnormalities but negative for EBV, CMV, HAV, HBV, HCV, and brucellosis. CT scan of the abdomen and pelvis showed hepatosplenomegaly along with sub-centimetric mesenteric lymphadenopathy. During his hospital stay, he developed pancytopenia. A blood smear showed 4% atypical lymphocytes and thrombocytopenia. The viral workup was repeated after 1 week of hospitalization and showed active CMV infection. During his stay, he developed desaturation and a persistent fever. A CT scan of the chest showed patchy areas of ground glass opacities in both lower lobes and in the lingula, consolidation in the right lower lobe, and small bilateral pleural effusions. The patient was subsequently diagnosed with CMV pneumonia, for which he was given a ganciclovir course. Our patient was eventually diagnosed with severe CMV hepatitis along with CMV pneumonia which is rare in an immunocompetent young male.

Conclusion: Acute CMV hepatitis is not uncommon in immuno-competent patients. Therefore, physicians ought to be vigilant to make a diagnosis of CMV infection in case of non-specific prodromal symptoms associated with acute hepatitis of unknown etiology. When indicated, anti-viral therapy should be given for 2 to 3 weeks followed by a documentation of CMV viral load clearance from blood.

Keywords: Cytomegalovirus; Immunocompetent; Pneumonia; Hepatitis

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Citation

Citation: Elias Fiani., et al. “Acute CMV Hepatitis and Pneumonia in A Young Immuno-Competent Male: A Case Report". Acta Scientific Gastrointestinal Disorders 7.7 (2024): 37-40.

Copyright

Copyright: © 2024 Elias Fiani., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.